Percutaneous pigtail catheter drainage of pancreatic pseudocysts.
OBJECTIVE
To evaluate the efficacy of percutaneous pigtail catheter drainage (PCD) in the management of pancreatic pseudocysts otherwise meriting surgical intervention.


METHODS
Fourteen consecutive patients with pancreatic pseudocysts (five following acute pancreatitis and nine with chronic pancreatitis) were subjected to PCD. For uncomplicated chronic pseudocysts, an algorithm using endoscopic retrograde pancreaticography to demonstrate ductal communication with obstruction was followed. Five patients had complicated pseudocysts and nine uncomplicated cysts persisting > 6 weeks and > 6 cm in size.


RESULTS
All uncomplicated and two complicated pseudocysts resolved in 6-58 days (mean 19.7). No recurrences were seen. Three patients with complicated cysts had pancreatic fistulae; two of these were treated by surgery and one by pancreatic stenting. Sepsis required sump drainage in two patients. Four patients required early surgery: two for pancreatic fistula and one each for hemorrhage and residual cyst. Two patients were subjected later to pancreatico-jejunostomy for pain of chronic pancreatitis.


CONCLUSIONS
Patients with acute pseudocysts and uncomplicated noncommunicating chronic pseudocysts respond to PCD. In complicated chronic pseudocysts, sepsis may be controlled by PCD.
Mathur
S K
SK
Gastroenterology Surgical Services, King Edward Memorial Hospital, Mumbai.
Shah
S R
SR
Balsarkar
D J
DJ
Rane
S
S
Khemani
R
R
D000208:Acute Disease; D000328:Adult; D002404:Catheterization; D002908:Chronic Disease; D004322:Drainage / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome